South Africa: Experts recommend ways of making health facilities more secure

10-04-2014 News Release 14/59

Pretoria/Geneva (ICRC) – Community acceptance, provision of impartial treatment and psychosocial support for medical staff working under stress can all play key roles in making health-care facilities more secure amid armed conflict or other emergencies.

These are some of the recommendations that emerged from a workshop that took place in Pretoria, South Africa, this week as part of the "Health Care in Danger" project on the dangers facing health-care services. The last in a series of consultations with experts, the event was co-hosted by the South African Department of International Relations and Cooperation (DIRCO) and the International Committee of the Red Cross (ICRC). It brought together representatives of the World Health Organization, the World Medical Association, Médecins Sans Frontières and other major organizations, as well as managers of health facilities in the field, some of whom are confronted with danger every day.

"It's a really good mix and extremely useful to combine international expertise with the experiences of people working in challenging places such as Iraq, Somalia, Israel and the occupied territories, and Mali," said Bruce Eschaya-Chauvin, medical adviser for the Health Care in Danger project. "What I found particularly interesting is that the protection of many hospitals in dangerous environments can be enhanced by soft measures rather than by armed guards or sophisticated equipment."

"We worked under stress, we faced fear, and yet our hospital was the only one that was not looted during the surge of violence," said Abdoul Aziz Ould Mohamed, who managed a hospital in Timbuktu, Mali, for the Alliance for International Action (ALIMA) in 2012. "In my opinion, what kept us safe was that we were in contact with all the armed groups, well-integrated into the community and constantly communicating about the need to spare medical services."

The ICRC recently reported that at least 1,800 incidents occurred in 23 countries in the last two years in which violence was used against patients, health-care personnel, ambulances or medical facilities. Forty per cent of the incidents were attacks on or within the facilities.

"South Africa decided to support this event because violence against people seeking or providing health care remains a serious concern, especially in countries on our continent and in particular in countries affected by armed conflict " said Pitso Montwedi, chief director of the humanitarian affairs directorate within DIRCO. "We believe that governments have a key role to play in promoting and implementing solutions."

Establishing a clear safety perimeter around hospitals and other health facilities, controlling entry points and setting up a secure supply chain for essential items are among the other measures the experts discussed.

"We will do our best to promote the recommendations via our network in more than 100 countries," said Eric de Roodenbeke, chief executive officer of the International Hospital Federation, at the end of the workshop as he signed a partnership agreement with the ICRC on the Health Care in Danger project. "Although not all of the hospitals we work with are affected by violence, we can certainly enhance preparedness in time of peace."

After Ottawa, Pretoria is the second capital city where experts have gathered to discuss the security of health facilities. The experts' recommendations will be published before the end of the year.